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How to Recognize Depression in Seniors and Where to Seek Help
- HHCS Staff
- May 1
- 3 min read
Have you noticed unusually unshakeable sadness in an older adult loved one lately? It’s normal for people to feel down every once in a while or deeply distressed if they’ve recently experienced a traumatic event. However, it’s not normal for feelings of depression to continue for more than a few weeks.
Depression can take many forms, from temporary and situational to chronic deep depression that requires immediate intervention. Do you know how to recognize symptoms of depression in your parent, friends, or other older adults in your life? Here are a few signs that might indicate something more serious than the average case of the blues:
Listen to verbal cues. Sometimes, depression is obvious when they complain about feeling lonely, express feelings of hopelessness, say things like, “You wouldn’t understand,” or even push you away with unusually negative behavior or anger. Some might be at a crisis point and express suicidal thoughts, say no one would miss them if they were gone, or that their life is pointless.
Watch for changes in their behavior: have they expressed a lack of interest in activities they usually enjoy? Do they have insomnia, or do they sleep too much? Have you noticed changes in their appearance: do they have poor hygiene, or have they lost or gained a lot of weight? Are they surrounded by excess clutter, dirty laundry, or are there unwashed dishes in the sink?
Sometimes, you just get a gut feeling that something’s “off” about them lately. So, how can you help your older loved ones get the treatment they need to overcome depression?
Often, the solutions are easy. Exercising, getting outside in the fresh air, eating a healthy diet, and connecting with friends and family can often help lift their spirits. However, depression that isn’t relieved by these lifestyle changes requires proper screening and treatment.
Unfortunately, seniors are less likely than younger adults to seek treatment for depression, so they might need an extra (gentle) nudge from you and a trip to the doctor.
Healthcare professionals have ways of screening patients for different levels of depression, from mild to severe. A triage nurse might start with a PHQ-2, a two-question form that asks if the patient has little interest or enjoyment in doing things, and if they’re feeling depressed or hopeless.
If one or both of the answers indicate depression on the PHQ-2, it’s followed up with the PHQ-9. The PHQ-9 is a 9-question form that goes into more detail and can help determine how severe the symptoms are. This form asks questions about sleep quality, energy level, appetite, feelings, etc.
The Beck Depression Inventory (BDI) and the Cornell Scale for Depression in Dementia are helpful questionnaires for depression screening in seniors. The 21-question BDI is more comprehensive than the PDQ-9.
Types of Depression:
Major Depressive Disorder: if depression lasts more than two weeks and interferes with everyday tasks, like basic hygiene, housework, etc.
Persistent Depressive Disorder (dysthymia) is depression that lasts over two years, but patients don’t neglect their everyday tasks.
Substance/medication-induced depressive disorder comes from abuse of prescription pain medications or alcohol, side effects of certain medications, or withdrawal.
Depressive disorder due to a medical condition: depression resulting from a separate illness that causes a reduced quality of life. This can be diabetes, heart disease, ALS, Alzheimer's, strokes, Multiple Sclerosis, etc., or any other diseases that dramatically affect a person’s ability to walk, function, care for themselves, etc.
Treatments:
Treatments include therapy, antidepressant medication, or a combination of both. SSRIs are popular medications for depression. If SSRIs don’t effectively treat these symptoms, SNRIs (Selective Serotonin and Norepinephrine Reuptake Inhibitors) might help.
Monoamine Oxidase Inhibitors (MAOIs) might be used for severe cases when SSRI and SNRIs have not been successful.
Cognitive Behavioral Therapy (CBT): This type of therapy helps patients identify negative thoughts that contribute to their feelings of depression.
Interpersonal Therapy (IPT): This therapy helps patients who have been socially isolated improve their communication skills and their relationships.
Other Psychotherapies range from Brief Dynamic Therapy (shorter-term therapy that focuses on one or two issues) to Reminiscence Therapy for patients with dementia or Alzheimer’s.
Where to go for help:
National Council on Aging:
No Wrong Door:
988:
If you or your loved one is experiencing an immediate mental health crisis, including suicidal thoughts, 988 is a free, confidential 24-hour suicide and crisis lifeline. Assistance is available in English and Spanish, with accessibility for Deaf/Hard of Hearing. For non-English/Spanish speakers, translation is available for over 240 languages (voice calling only). Resources are also available for veterans and service members.
988 Suicide & Crisis Lifeline
Call the 988 Suicide & Crisis Lifeline at 988 or 800-273-TALK (800-273-8255).
Text: 988
Deaf/Hard of Hearing:
(TTY): 711, then 988, or 800-799-4889
988 is also accessible via Videophone.
Text: 988
Helpful links for more information:
National Institute on Aging:
CDC Healthy Aging:
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